Infusing fresh blood using PDIA in Nigeria’s Blood Services

Guest blog by Adaeze Oreh

When I signed up for the Harvard Kennedy School Implementing Public Policy programme, I thought I knew quite a bit about my policy challenge! I was applying to the programme basically to figure out new concepts and get new tools that would help me as Director of Planning for Nigeria’s Blood Services agency implement those ideas my organisation already had about solving Nigeria’s blood safety problem. You see, my country has a population of over 200 million people and for decades has been bedevilled by a frustrating lack of ready availability of safe blood to meet the country’s needs. This gap has contributed immensely to high maternal death rates, and the large number of children who die before the age of five. As an organisation, we had some ideas in our toolbox to address this, and I hoped IPP under Matt Andrews and the HKS faculty’s guidance would provide the magic bullet for implementation. I was not prepared for the level of insight that the course would provide.

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Tackling Blood Safety in Nigeria

Guest blog written by Allan Franklin, Dana Radojevic, Hesham Gaafar, Lauren Truong

This is a blog series written by students at the Harvard Kennedy School and the Harvard School of Public Health who completed “PDIA in Action: Development Through Facilitated Emergence” (MLD 103) in March 2021. These are their learning journey stories.

Over the past 8 weeks, we had the opportunity to work with the National Blood Transfusion Service (NBTS) on the lack of safe blood in Nigeria. The lack of safe blood during emergencies such as car accidents or postpartum hemorrhages has led to high numbers of preventable deaths.

Upon learning about our project, we were afraid that our lack of knowledge and experience in public health would limit our progress, but the Problem Driven Iterative Adaptation (PDIA) process showed us how addressing major problems such the lack of safe blood in Nigeria requires learning on the fly, using the diverse perspectives and contributions of our teammates, and constantly reflecting and improving on our work.

Here are some of our key learnings:

Focus on the problem, not the solution.

It is our nature as humans to be solution-oriented and not problem-focused. Is the lack of safe blood in Nigeria due to the low number of voluntary donors the problem? Or is it a combination of supply-sideand demand-side factors? Instead of assuming what the possible solutions could be, the PDIA process slowed us down and forced us to get uncomfortable and ask hard questions. This helped us identify the problem at hand and helped us construct our fishbone diagram.

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